Comparison of Apraclonidine and Timolol in Chronic Open-angle Glaucoma

Nagasubramanian, S.; Hitchings, Roger A.; Demailly, P; Chuniaud, Michèle; Pannarale, M. R.; Pecori-Giraldi, J; Stodtmeister, Richard; Parsons, David G.

doi:10.1016/s0161-6420(13)31818-1

Cited by 51 publications

(11 citation statements)

References 10 publications

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“…Topical antiglaucomatous agents which are used in the long-term treatment of glaucoma can lead to some degeneration on the ocular surface [10, 11, 12, 13, 14, 15]. In previous studies, topically applied β-blockers have been found to cause a decrease in lacrimation and abnormality in the mucin layer [5, 10].…”

Section: Discussionmentioning

confidence: 99%

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Ultrastructural Effects of Topical Beta-Adrenergic Antagonists and an Alpha-Adrenergic Agonist on the Rabbit Cornea

Polat¹,

Özdemir

Soylu

et al. 1999

Ophthalmologica

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In the present study the effects of β-adrenergic antagonist and α-adrenergic agonist drugs on rabbit corneas were evaluated in vivo by using transmission electron microscopy. Twenty-four New Zealand albino rabbits were divided into six groups according to the drug applied. The rabbits to which only balanced salt solution (BSS) or BSS and benzalkonium chloride (BAC) were applied were taken as the control groups. The other four groups consisted of the rabbits to which Timoptic 0.5%, Betagan 0.5%, Betoptic 0.5% and Iopidine 1% were applied, respectively. All of drugs were instilled topically twice daily for 6 weeks. In the BSS group, all layers of the cornea were ultrastructurally normal. In the BSS and BAC group slight epithelial and endothelial changes were found. However, in the other groups, loss of microvilli, increase in glycogen particles, nuclear indentation, widening of the intercellular spaces and cytoplasmic vacuolization in epithelium were observed. No significant abnormality was found in the basal lamina, stroma and Descemet’s membrane. Slight ultrastructural changes were noted in the endothelium such as vacuolization due to dilatation of the endoplasmic reticulum cisternae and focal cytoplasmic lytic areas. The results of this study indicate that various ultrastructural changes occur in groups treated with antiglaucomatous drug and that topical treatment with timolol and apraclonidine for 6 weeks is more toxic to the rabbit cornea than levobunolol and betaxolol.

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Section: Discussionmentioning

confidence: 99%

“…Also it has been detected that they are toxic to the corneal epithelium, cause a delay of epithelial regeneration and are hazardous to the endothelium [11, 12, 13]. It is known that apraclonidine has ocular side effects such as conjunctival blanching, mydriasis, foreign-body sensation and congestion [6, 14, 15]. …”

Section: Discussionmentioning

confidence: 99%

Ultrastructural Effects of Topical Beta-Adrenergic Antagonists and an Alpha-Adrenergic Agonist on the Rabbit Cornea

Polat¹,

Özdemir

Soylu

et al. 1999

Ophthalmologica

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“…Studies to date have shown excellent patient acceptance of the topical carbonic anhydrase inhibitor dorzolamide[24-27j and the prostaglandin analogue latanoprost, which suggests that these 2 drugs may be useful as single agent therapy and as initial therapy in newly diagnosed glaucoma patients.l 73 ,76,77] Data from the compassionate case trials of apraclonidine [46][47][48] and brimonidine [49] suggest these drugs are well tolerated. The high incidence of blepharo-conjunctivitis noted during the 3-month evaluation of apraclonidine [45] needs to be re-evaluated in other clinical trials. Local ocular adverse effects of ethacrynic acid [81 ,85] need to be resolved before the drug can be considered for long term topical clinical use.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Advances in the Treatment of Glaucoma

Serle

1994

Drugs & Aging

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Glaucoma is a potentially blinding disease. The goal of glaucoma therapy is to reduce intraocular pressure to a predetermined target level. There are currently 5 classes of compounds used for the medical management of glaucoma. Four classes that appear promising for the long term management of glaucoma are in different phases of clinical investigation, and include the topically active carbonic anhydrase inhibitors, selective alpha 2-adrenergic agonists, prostaglandins and ethacrynic acid. The topically active carbonic anhydrase inhibitor dorzolamide (MK-507) is effective and well tolerated in clinical trials of up to 1 year's duration. Animal studies have demonstrated that this drug lowers intraocular pressure by reducing aqueous humour formation. The selective alpha 2-adrenergic agonists, brimonidine and apraclonidine, have been shown to be effective in reducing intraocular pressure in the short term. Long term effectiveness of these agents is under investigation. Prostaglandins (PG) of the PGF2-alpha isopropylester series caused marked reductions of intraocular pressure in laboratory and clinical trials. The newest prostaglandin analogue, latanoprost (PhXA41), effectively lowered intraocular pressure and was well tolerated in clinical trials of up to 4 weeks' duration. Prostaglandins reduce intraocular pressure by enhancing uveoscleral outflow. Ethacrynic acid enhanced traditional outflow facility and lowered intraocular pressure when applied topically or intracamerally in laboratory studies and clinical trials. Corneal adverse effects of ethacrynic acid have been noted. Reformulation of ethacrynic acid ointment may resolve this problem. These 4 classes of compounds will enhance our options for the medical management of glaucoma. They may be used instead of or in combination with some of the drugs currently in use, and may be better tolerated.

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“…Brimonidine is commonly used twice daily, particularly when used as an adjunctive agent, although it is approved for therapy three times a day. Tachyphylaxis in long-term use and allergic reactions such as follicular conjunctivitis, contact blepharitis-and dermatitis are less frequently seen (up to 50 % for apraclonidine, less than 9 % for brimonidine) [44] than for apraclonidine.…”

Section: Adrenergic Agonistsmentioning

confidence: 99%

“…Apraclonidine hydrochloride is commercially available in concentrations of 0.5 % and 1.0 %. Administered three times daily it has the same hypotensive effect as timolol 0.5 % twice daily [44]. The development of topical sensitivity and tachyphylaxis often limits long-term use of apraclonidine hydrochloride [43].…”

Section: Adrenergic Agonistsmentioning

confidence: 99%

Topical Drug Therapy in Glaucoma

Resch

Garhöfer

2006

Wien Med Wochenschr

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Glaucoma is defined as a progressive optic neuropathy involving characteristic structural changes in the optic nerve head and corresponding visual field defects. Elevated intraocular pressure (IOP) is a major risk and causative factor for glaucomatous optic neuropathy. Although mechanisms other than elevated IOP may contribute to the underlying pathophysiology of glaucoma, reducing IOP remains the primary goal of therapy. Recent clinical studies have shown that decreasing the IOP can delay, or in some cases prevent progression of this chronic ocular disease. Over the past decade, several new medical therapies have become available for the treatment of glaucoma. In this article a review of topical glaucoma therapy is presented.

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Comparison of Apraclonidine and Timolol in Chronic Open-angle Glaucoma

Cited by 51 publications

References 10 publications

Ultrastructural Effects of Topical Beta-Adrenergic Antagonists and an Alpha-Adrenergic Agonist on the Rabbit Cornea

Ultrastructural Effects of Topical Beta-Adrenergic Antagonists and an Alpha-Adrenergic Agonist on the Rabbit Cornea

Pharmacological Advances in the Treatment of Glaucoma

Topical Drug Therapy in Glaucoma

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